血清microRNA-21、microRNA-193a-3p表达与结直肠癌患者手术预后的关系

The relationship of preoperative serum microRNA-21, microRNA-193a-3p levels with postoperative prognosis of colorectal cancer patients

摘要:

目的 探究血清microRNA-21（miR-21）、microRNA-193a-3p（miR-193a-3p）水平与结直肠癌患者手术预后的关系。方法 回顾性分析2020年1月—2022年1月苏州大学附属第一医院收治112例结直肠癌患者的病历资料。患者均接受结直肠癌根治术，术后随访16个月，记录患者的预后生存结局，多因素逐步Logistic回归分析结直肠癌患者手术预后的影响因素，评估血清miR-21、miR-193a-3p对结直肠癌患者预后的预测效能。结果 112例结直肠癌患者死亡22例，病死率为19.64%；生存90例，生存率为80.36%。死亡组术前血清miR-21 mRNA相对表达量、临床分期Ⅲ期占比、淋巴结转移率均高于生存组（P <0.05），血清miR-193a-3p mRNA相对表达量低于生存组（P <0.05）。多因素逐步Logistic回归分析结果显示，临床分期Ⅲ期［O^R=3.777（95% CI：1.399，10.194）］、淋巴结转移［O^R=5.099（95% CI：1.715，15.156）］、miR-21表达升高［O^R=4.889（95% CI：1.645，14.533）］、miR-193a-3p表达降低［O^R=4.402（95% CI：1.481，13.084）］均是直肠癌患者预后的影响因素（P <0.05）。受试者工作特性曲线分析结果显示，血清miR-21、miR-193a-3p单一及联合预测结直肠癌预后的敏感性分别为69.04%（95% CI：0.487，0.813）、72.73%（95% CI：0.495，0.884）、86.36%（95% CI：0.640，0.964），特异性分别为62.22%（95% CI：0.513，0.720）、68.89%（95% CI：0.581，0.780）、90.00%（95% CI：0.814，0.950），曲线下面积分别为0.782、0.731和0.901。结论 结直肠癌患者术前miR-21、miR-193a-3p表达与术后预后密切相关，且在结直肠癌患者的预后结局中表现出良好的预测效能。

Abstract:

Objective To investigate the relationship between preoperative serum levels of microRNA-21(miR-21) and microRNA-193a-3p (miR-193a-3p) and the postoperative prognosis of colorectal cancer patients.Methods A retrospective analysis was conducted on the medical records of 112 colorectal cancer patients admitted to the First Affiliated Hospital of Soochow University from January 2020 to January 2022. All patients underwent radical surgery for colorectal cancer and were followed up for 16 months. The prognosis and survival outcomes were recorded and categorized into survival and death groups. Factors influencing the prognosis of colorectal cancer patients were analyzed, and the predictive efficacy of serum miR-21 and miR-193a-3p on colorectal cancer prognosis was evaluated.Results Among the 112 colorectal cancer patients, 22 died, resulting in a mortality rate of 19.64%, while 90 cases (80.36%) survived. The relative expression levels of serum miR-21 RNA, proportion of TNM stage Ⅲ, and lymph node metastasis rate were higher in the death group compared to the survival group, whereas the relative expression level of serum miR-193a-3p mRNA was lower in the survival group. Logistic stepwise regression analysis revealed that TNM stage Ⅲ [O^R = 3.777 (95% CI: 1.399, 10.194)], lymph node metastasis [O^R = 5.099 (95% CI: 1.715, 15.156)], increased relative expression of miR-21 mRNA [O^R = 4.889 (95% CI: 1.645, 14.533)], and decreased relative expression of miR-193a-3p mRNA [O^R = 4.402 (95% CI: 1.481, 13.084)] were significant factors influencing the prognosis of colorectal cancer patients (P < 0.05). Receiver operating characteristic curve (ROC) analysis showed that the sensitivity of serum miR-21 and miR-193a-3p in predicting colorectal cancer prognosis were 69.04% (95% CI: 0.487, 0.813), 72.73% (95% CI: 0.495, 0.884), and 86.36% (95% CI: 0.640, 0.964), respectively, with specificities of 62.22% (95% CI: 0.513, 0.720), 68.89% (95% CI: 0.581, 0.780), and 90.00% (95% CI: 0.814, 0.950), and area under the curve (AUC) values of 0.782, 0.731, and 0.901, respectively.Conclusion Preoperative expression levels of miR-21 and miR-193a-3p in colorectal cancer patients are closely associated with postoperative prognosis and demonstrate good predictive efficacy for colorectal cancer prognosis.